Abstract： In the view of Chinese medicine， the pathogenesis of chronic fatigue syndrome （CFS） is closely associated with dysfunction of the spleen and stomach. The authors recommend that the earth-supplementing theory is fundamentally relevant to the onset and development of CFS. The onset of CFS originates from the failure of transportation and transformation due to deficiency of spleen qi， of which predominant dampness due to spleen deficiency， and middle-jiao stagnation constitute the pathological basis of CFS. Disorder of qi movement， and qi stagnation and liver depression serve as the key pathogenic determinants， while phlegm blended with blood stasis due to long-standing illness forms the key pathological progression of CFS. Thus the therapeutic principles should prioritize supplementing deficiency while secondarily purging excess， focusing on nourishing the spleen and stomach， and restoring qi movement of middle-jiao. For acupuncture intervention， principal points can be selected from the conception vessel， foot-taiyin spleen meridian，and foot-yangming stomach meridian，including：Qihai（ RN6） point，Guanyuan（ RN4） point， Zusanli （ST36） point， and Sanyinjiao （SP6） point to invigorating spleen and stomach， and banking up middle-jiao. Adjunctive therapies may include dampness-draining， qi-regulating， phlegm-resolving， and bloodactivating as clinically indicated.